Background: Coronavirus disease 2019 (COVID-19) is commonly complicated with coagulopathy presented with venous thromboembolism and arterial thromboses. The aim of this study was to evaluate the effect of routine thromboprophylaxis with low molecular weight heparin (LMWH) on clinical outcomes including mortality and need for intensive care unit (ICU) admission in hospitalized COVID-19 patients. Methods: All confirmed patients with COVID-19 hospitalized to COVID-19 dedicated wards, from March 15 to May 15, 2020, were included in this retrospective cohort study. Two groups of patients were established, according to the non-routine and routine application of LMWH with therapeutic, weight-based, anticoagulation dosing. Clinical, laboratory and treatment data were collected, analyzed and compared between the two groups. A logistic regression model was developed to assess the factors related to in-hospital adverse outcomes. Results: A total of 1511 patients (797 men, median age 59.0 years) were retrospectively analyzed (Group non-routine LMWH (n=828); group routine LMWH (n=683)). Multivariate logistic regression analysis showed routine use of LMWH, favipiravir administration, extreme values of WBC count, NLR, and troponin I as factors independently associated with in-hospital adverse outcomes (OR=0.25, 95% CI: 0.83-0.91; p<0.001 for routine use of LMWH). Conclusion: Routine thromboprophylaxis with LMWH reduced mortality and ICU admission in patients admitted with COVID-19 infection.

Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative top re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was lower in pandemic group and distal embolization and TIMI thrombus score were significantly higher in the pandemic group compared top re-pandemic group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no statistically significant difference in hospital mortality and short –term all cause mortality, among groups (p>0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.

Background Patients with end-stage renal disease have an increased risk of cardiac events. Although preemptive renal transplantation decreases mortality that is associated with dialysis, coronary artery disease remains as the primary cause of mortality even after transplantation. In this context, diabetic patients are more prone to adverse cardiac events. We aimed to compare the incidence of coronary artery disease and long-term survival rates in preemptive and non-preemptive diabetic renal transplantation recipients. Methods Diabetic patients with end-stage renal disease who underwent coronary angiography before renal transplantation were included retrospectively. These patients were divided into two groups as preemptive and non-preemptive according to transplantation strategy. Angiographic findings, particularly the severity of coronary artery disease, were compared between the two groups. Long-term all-cause mortality rates were also compared. Results A total of 164 patients were included in the study. Of these patients, 125 (78%) were male, and the median age was 54 (Q1-Q3=45-59). The extent of coronary artery disease, revascularization rates SYNTAX and Gemini scores were similar between the two groups (all p>0.05). During 4,8 years of follow-up was there was no statistical difference in all-cause mortality rates (HR=0.59,[0.20–0.71],p[log-rank]=0,33). Multivariate Cox regression analysis revealed that only age and hyperlipidemia were predictive of all-cause mortality (HR=1.03 [1.001-1.07], p=0.04 and HR=2.75 [1.20-6.28], p=0.01 respectively) Conclusion The prevalence, severity and revascularization rates of coronary artery disease were similar between the preemptive and non-preemptive diabetic renal transplant recipients. Also, there was no statistical difference in all-cause mortality rates during long-term follow-up. Keywords Kidney, coronary, diabetes, transplantation, preemptive What’s known? : Although preemptive kidney transplantation is advantageous since dialysis is not applied, cardiovascular diseases are the most important cause of morbidity. What’s new: Comparison of patients with and without preemptive transplantation in the diabetic patient group in terms of coronary artery disease and survival has not been performed